POS0874 DO PATIENTS WITH PSORIATIC ARTHRITIS EXPERIENCE MORE FEELINGS OF SHAME AND GUILT THAN PATIENTS WITH RHEUMATOID ARTHRITIS?
Authors: H. Boussaa, E. Hannech, A. Fazaa, S. Miladi, M. Yasmine, L. Souabni, K. Ouenniche, S. Kassab, S. Chekili, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with rheumatoid arthritis (RA) may experience feelings of guilt and shame related to the impact of the disease on their quality of life. However, patients with psoriatic arthritis (PsA) face an aesthetic problem in addition to the functional disability. <h3>Objectives</h3> The purpose of this study was to determine whether patients with PsA experience more feelings of shame and guilt than patients with RA. <h3>Methods</h3> We conducted a cross sectional study including patients with RA (ACR/EULAR criteria) and PsA (CASPAR criteria). Feelings of guilt and shame were assessed using the Experience of Shame Scale (ESS) [1] and the Test of Self Conscious Affect- Version 3 (TOSCA-3S) [2]. ESS is a self-report scale assessing 3 areas: (1) characterological shame (2) behavioral shame and (3) bodily shame. Each item was rated in a 4-point Likert scale. Higher scores indicate higher levels of shame. TOSCA-3S is composed of 11 scenarios, each followed by 4 possible responses. Each item was rated in a 5-point Likert scale. This score measures shame-proneness, guilt-proneness, detachment and externalization (blaming others). Only the shame and guilt subscales of the TOSCA-3S were used for the statistical analysis. A p&lt;0.05 was considered significant. <h3>Results</h3> A total of 40 RA patients (36 women, 4 men) and 30 PsA patients (12 women and 18 men) were included. The mean age was 54 years [25-75] and 51 years [21-80], respectively. The mean disease duration was 12 years [3-33] in RA patients and 13 years [2-20] in PsA patients. Illiteracy was noted in 22% of RA patients and in 5% of PsA patients. Regarding the professional status, 42% of RA patients and 50% of PsA patients were employed. High disease activity was noted in 42% of RA patients and in 13% of PsA patients. The mean total score of ESS was 45 [27-80] in RA and 65 [31-98] in PsA. There was a significant difference between the groups (p&lt;0.001). The mean subscale scores were significantly higher among PsA patients: the characterological shame (29 vs 19, p=0.05), the behavioral shame (25 vs 18, p=0.001), and the bodily shame (10 vs 7, p&lt;0.001). For the TOSCA-3S, the mean "shame self-talk Total" score was higher in PsA patients, but the difference was not significant (35 vs 33, p=0.453). The mean "guilt self-talk Total" score was 48 in RA and 47 in PsA (p=0.341). <h3>Conclusion</h3> Feelings of guilt and shame are experienced by both PsA and RA patients. However, PsA may have a higher psychosocial impact. Therefore, effective management of the dermatological and psychological aspects is necessary. <h3>References</h3> [1]Andrews B, Qian M, Valentine JD. Predicting depressive symptoms with a new measure of shame: the Experience of Shame Scale. Br J Clin Psychol 2002;41:29-42. [2]Tangney JP, Dearing RL, Wagner PE, Gramzow R (2000) The Test of Self-Conscious Affect-3 (TOSCA-3). George Mason University, Fairfax. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.